Provider Demographics
NPI:1508351503
Name:LIVINGSTON, JENNIFER M (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:1444 S POTOMAC ST
Mailing Address - Street 2:STE 220
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4509
Mailing Address - Country:US
Mailing Address - Phone:303-668-2699
Mailing Address - Fax:
Practice Address - Street 1:8805 W 14TH AVE STE 320
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4850
Practice Address - Country:US
Practice Address - Phone:303-668-2699
Practice Address - Fax:303-895-2351
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0996484363LP0808X
COAPN0996484-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health